Objective To study the value of CT and MRI in diagnosis of Caroli disease. Methods CT and MR findings in 10 patients with histologically proved Caroli disease were retrospectively reviewed. All the patients underwent both liver plane CT and contrast-enhanced CT. Five of 10 patients underwent MR imaging with Flash 2D T_1WI(TR/TE 148/4ms), True Fisp T_2WI(TR/TE 5.8/2.9ms) and MRCP(TR/TE 1120/86ms) sequences. Results The imaging paremeters of Caroli disease were multiple saccular/columnar dilatation of intrahepatic biliary ducts and communication with each other, which only partly were depicted at CT, however, all imaging findings were depicted at MRI True Fisp and MRCP without contrast-enhanced scanning. Of 10 patients, 4 cases were type Ⅰ of Caroli disease with hepatolith, but without hepatic cirrhosis and portal hypertention; 6 cases type Ⅱ,all complicated with hepatic cirrhosis and portal hypertension. Of 6 patients with type Ⅱ Caroli disease, 4 cases had not hepatolith, and 2 cases had hepatolith. Of 10 patients, 3 cases had bilateral sponge kidney. Conclusion Caroli disease could be identified by CT or MRI, but MRI was superior to CT in depicting Caroli disease.

Objective To analyze the MRI characteristics of hematospermia seminal vesiculitis(HSV) and evaluate the diagnostic value of MRI in HSV. Methods The MRI parameters of 25 HSV patients underwent magnetic resonance imaging(MRI) imaging with SE T 1WI(TR/TE 558/14ms), Flash 2D water excitement(TR/TE 18.5/5.2ms), TSE T 2WI(TR/TE 4000/99ms) and fat suppression sequences were retrospectively analyzed. Results The bilateral seminal vesicles in all 25 patients with HSV enlarged. On SE T1-weighted images, intraseminal vesicle hemorrhage appeared as high signal intensity, which appeared more bright on Flash 2D water excitement sequence. The hypointensive duct wall of seminal vesicles could be clearly seen because of hyperintensive hemorrhage. On TSE T2-weighted images, intraseminal vesicle hemorrhage appeared as relatively lower signal intensity, and the duct wall of seminal vesicles could not clearly be depicted for being covered with relatively hypointensive hemorrhage. Conclusion Hematospermia seminal vesiculitis could be identified by MRI, and MRI was the best imaging method for examining hematospermia seminal vesiculitis.

The pancreatic tissues from patients with islet cell hyperplasia,insulinoma,and pancreatic adenocarcinoma,as well as normal pancreatic tissues were embedded with paraffin,serial sections were cut and mounted on glass slides.Immunohistochemical staining was carried out with N-myc down-stream regulated gene 2 (Ndrg2) monoclonal antibody by means of ABC method,and Western blotting was carried out to detect the expression and distribution of Ndrg2.The results showed that Ndrg2 positive immunoreactivity was mainly localized in the cytoplasm of islet cell,being similar to the localization of insulin positive immunoreactivity.The number and volume of pancreatic islets were increased in the patients with islet cell hyperplasia,and Ndrg2 expression was also increased.Western blotting results showed that the expression of Ndrg2 in the pancreas of patients with islet cell hyperplasia was increased compared with normal group.The above results suggest that Ndrg2 may play an important role in performing physiological function of islet cells.

Objective To assess the effects of Danhong injection on the perfusion function of the pancreas in patients with acute pancreatitis (AP). Methods A total of 102 patients with AP were collected, and there were 25 patients with severe acute pancreatitis ( SAP) and 77 patients with mild acute pancreatitis (MAP). They were randomly divided into routine treatment group ( RTG,n =54) and Danhong treatment group (DTG,n =48) , respectively. Another 33 normal individuals were used as controls. Patients in RTG received gastric decompression, acid inhibition, anti-infection and nutritional support. Patients in DTG received Danhong injection 30 ml i. v. b. i. d besides routine treatment. The hemodynamic parameters ( BF, BV, MTT, and PS) of perfusion of the pancreas were measured by 16-slice spiral CT scanner. Results The values of BF of control, MAP, SAP group were time was ( 12.6 ± 2.7) d in DTG, which were significantly shorter than those in routine treatment group [(14.5 ±3.2)d, (18.5 ±5.5)d, P <0.05]. Conclusions The parameters of CT perfusion imaging of the pancreas can be a quantitative criterion to assess the severity of microcirculation dysfunction in patients with AP, and Danhong injection is effective to improve the blood perfusion of the pancreas during the treatment of AP.

Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.

An electronic medical record(EMR)system is built at urban community health centers to optimize services,achieving information integration of outpatient medical services based on the doctors' workstation.This system has optimized service at the outpatient clinics in the following:1.Digitizing service processes for higher efficiency and service quality; 2.Using EMR templates to save doctors' time in writing medical records for more of their time in patient inquiries and checks; 3.Using LIS,PACs and ECG/EKC systems to check lab results and imaging diagnostics of patients; 4.Using the diagnostic and therapy record sub-system to check electronic records of the patients for consulting their health history;5.Using the Shanghai Medical Alliance's(SMA)shared sub-system to acquire patients' medical records at SMA medical institutions,learning their conditions for their therapies.EMR,when it is built and put into use,can help improve GP's diagnostics and therapeutics,and provide better care to the outpatients as well.

Objective To investigate the reasons of artifacts in 64-slice spiral CT coronary angiography.Methods One hundred patients with diagnosed or suspected coronary artery disease underwent retrospectively ECG-gated 64-slice spiral CT coronary angiogruphy.Maximum intensity projection(MIP),muhiplanar reformation(MPR)and volume rendering technique(VRT)were reconstructed.The reasons of artifacts were assessed by two experienced radiologists.Results A total of 1347 segments(1347/1500,89.8%)were reviewed,the artifacts were found in 192 segments(14.2%).Breath movement was the moat common artifact(124/192).and the other reasons included fast rate and irregular rhythm of the heart beat (42/192).while the phase mismatch was the third reason(22/192).Conclusions The common artifacts of 64-slice spiral CT coronary angiography includes breath movement,fast rate and irregular rhythm of heart beat and phage mismatch.Breath-holding control,low rate and regular rhythm of heart beat,muhiphage reconstruction are suggested for the accurate diagnosis.

PurposeTo assess the level of agreement and interchangeability among Excel and CMRtools (2012) for calculation of T2* values in iron overload.Materials and Methods T2* images in 27 cases withβ-thalassemia major were imported into CMRtools (2012). The regions of interest (ROI) were drawn and interference signal removed to obtain T2* values. The T2* images were also measured using default MR software and manually entered into Excel to obtain T2* values after removal of the interference signal. The agreement between the two methods in calculating T2* values was compared.Results For 27 patients withβ-thalassemia major, 10 cases showed myocardial iron overload. 25 cases had liver iron overload. The T2* values from two methods were not statistically significant (t=-0.152 and-0.691,P>0.05) for the liver.Conclusion There is good agreement and interchangeability between Excel and CMRtools (2012) in calculating T2* values. Excel can be used clinically to evaluate iron overload.

Objective:To investigate occurrence and nursing care of complications after the surgery of abdominal liposarcoma. Methods:The postoperative complications and nursing efficacy in 76 patients with abdominal liposarcoma treated in the Depart-ment of General Surgery,Zhongshan Hospital,Fudan University from Jul 2009 to Jun 2014 were retrospectively analyzed.Re-sults:In 76 patients,there were 12 cases of anastomotic leakage,1 8 cases of infections,13 cases of various effusions,1 case of massive hemorrhage and 1 case of deep vein thrombosis.And 5 cases were initially discovered in the nursing process and 33 were diagnosed after a report of abnormal founding by nurses.All were successfully recovered after treatment and nursing.Con-clusions:Active nursing work with a high quality is vital to prevent and treat the postoperative complications after the surgery of abdominal liposarcoma.

Objective:To investigate differentially expressed genes(DEGs)for neuropathic pain between sciatica and healthy controls. Method:The microarray dataset GSE150408 were downloaded from gene expression database(gene expression omnibus database,GEO).The DEGs were screened using the limma V3.42.0(linear models for microarray da-ta)package of the R software program(version 3.5.0).GEO terms and Kyoto encyclopedia of genes and ge-nomes(KEGG)pathway enrichment analysis of DEGs were automatically completed and visualized by the clus-terProiler V3.14.0.STRING was searched to identify and predict interactions between genes or proteins,to con-struct the protein to protein interaction. Result:A total of 424 DEGs were screened,including 233 up-regulated genes and 191 down-regulated genes.The result of GO enrichment indicated that for biological process,DEGs were significantly enriched in de-fense response,regulation of immune system process,cell activation,leukocyte activation.Regarding cell com-ponents,DEGs were significantly enriched in vesicles,secretory granules,tertiary granule.For molecular func-tion,DEGs were significantly enriched in immune receptor activation,complement receptor activity and MAP kinase phosphatase activity.The result of KEGG pathway-enrichment indicated that DEGs were mainly enriched in transcriptional misregulation in cancer.Moreover,the GSEA analysis indicated that the most significant en-riched gene sets included endocytosis,Epstein-Barr virus infection.PPI analysis were performed to explore the potential function of the DEGs.It showed that the degree of FCGR1A was the highest in up-regulated proteins and the highest in down-regulated proteins.These two proteins were the key nodes. Conclusion:It showed an inflammatory and immune characteristic in peripheral blood for neuropathic pain.AZU1,BPI,FCGR1A and SPTBN2 were the key genes in neuropathic pain.